The Virginia Voice Of

The Virginia Voice of Spring 2006

VET-MED

DEPARTMENT OF HEALTH PROFESSIONS

President’s Message

The year 2005 has come and gone. Having served on the Board of Veterinary Medicine for two years now, I would like to take this opportunity to thank Dr. Andrew Horner for his excellent service to the Board for the past eight years. Dr. Horner was replaced by Dr. James DeBell this past year, and he is serving us well. Thanks, also, to Vice-President Dr. Bud Siemering, Dr. Henry McKelvin, Dr. Jana Froeling, Citizen Member Ms. Dorothy Blackwell, and Secretary/Treasurer and Licensed Veterinary Technician Member Rebecca Lakie. It is a pleasure to serve with these members.

I might mention the reduction in the fees for veterinary, licensed veterinary technicians, and faculty licenses the Board of Veterinary Medicine has made effective for 2006. We are pleased to be able to reduce these fees.

We enjoyed our panel discussion at the Annual Virginia Veterinary Medical Association meeting in Roanoke on Thursday evening, February 2nd, with the VVMA membership. It seemed to be well received.

This has been a good year for the Board of Veterinary Medicine. Our case load has kept us busy, but wasinteresting. I am grateful for the opportunity to serve as your President of the Board of Veterinary Medicine for the past two years.

Sincerely,

John T. Wise, DVM

President

Members of the Board

John T. Wise, DVM
President
First full term expires
June 30, 2009
Staunton / George H. Siemering, DVM
Vice-President
First full term expires
June 30, 2008
Springfield / Rebecca A. Lakie, LVT
Secretary-Treasurer
First term expires
June 30, 2007
Chester
James W. DeBell, DVM
First term expires
June 30, 2009
Richmond / Dorothy S. Blackwell
First term expires
June 30, 2007
Lexington / Jana Froeling, DVM
First term expires
June 30, 2008
Amissville / Henry McKelvin, DVM
First term expires
June 30, 2006
Hampton

DRUG-RELATED ISSUES ON THE RISE

Every year the Board has one or two complaints involving allegations of drugs obtained by fraud, drugrecordkeeping errors, and drugs not being maintained in a secured manner. However, in 2005, the Board received 17reportsof this nature and was made aware of a number of thefts. With the high street value for Schedule II through V prescription drugs, criminals have become acutely aware of the controlled substances and prescription pads available at veterinary facilities.

The abuse of controlled substancesin the United States is a serious social and health problem. Professionals in the veterinary community share in the responsibility for preventing prescription drug diversion. To that end, it is important to remember thatall controlled substancesand the prescription pads that provide access to them must be maintained in a secured manner so that they are available only for legitimate medical purposes. These should be locked with the keys or combinations accessible ONLY to licensees. Only licensed veterinarians and licensed veterinary technicians (actual licensees with current licenses) may have access for legitimate reasons. Further, the licensed veterinary technicians may only have access to a secured working stock.

Unlicensed personnel may NOT have access to federally controlled substances, period.

Although the variety of settings in which veterinary care is rendered sometimes makes security a challenge, especially formobile practices, it is still essential for veterinarians-in-charge to maintain all controlled substances (not just Schedule II) in a secured manner. This means that they must be locked up with access to the key or combination effectively restricted to the appropriate licensees. It does not mean locking the drugs in a box that can easily be removed or placing the key on a ring on the wall or in a coat pocket easily accessible to unlicensed staff or the public.

Recently, the Board office has been asked about how to appropriately report drug thefts or other unexplained losses. The following provides Board guidance.

Whenever a theft or any other unusual loss of any controlled substance is discovered, the Veterinarian-in-Charge is to immediately report such theft or loss toall of the following:

1. Virginia Board of Veterinary Medicine (in writing by fax at 804-662-7098, by e-mail at , or by regular mail at 6603 W. Broad Street, Fifth Floor, Richmond, VA 23230-1712);

2. U.S. Drug Enforcement Agency (use DEA Form 106 obtainable from: and

3.Local Police.

If the Veterinarian-in-Charge is unable to determine the exact drugs and quantity of the drug loss, he shall immediately make a complete inventory of all Schedule I through V drugs.

VETERINARY FACILITIES STILL CANNOT ACT AS PHARMACIES

The December 1999 edition of the Virginia Voice of Vet-Med informed licensees that veterinary facilities may not act as pharmacies. Although there have been no changes in Virginia statutes to change that fact, the Board office still receives questions about this from time-to-time. Below is a reprint of the original article.

Veterinary Facilities Cannot Act as Pharmacies

Questions about whether one veterinary facility can "fill prescriptions" for a patient seen by a veterinarian at another facility often arise. The answer is "no." There is no provision in Virginia law which allows for veterinary facilities or any other establishment not duly licensed by the Board of Pharmacy to dispense controlled substances to fill a prescription.

Veterinarians are allowed to prescribe, administer, and dispense controlled substances in keeping with the requirements of the Virginia Drug Control Act, specifically §54.1-3409 of the Code of Virginia, and the statutes and regulations governing the practice of veterinary medicine. A valid veterinarian-client-patient relationship must first exist before drugs can be dispensed by a veterinary facility to their own patients.

Updates to the Statutes and Regulations

Changes to the required format for prescription pads will take effect on July 1, 2006. Also, the Board's Regulations have been amended this year to 1)require notification on the rabies certificate of the latency period required before vaccine full effectiveness is achieved and to 2)provide a one-time reduction in renewal fees. Also, because the laws, regulations, and Board guidance documents update on an ongoing basis, please check the Board's website for the latest information on Virginia's governing of veterinary medicine:

Drug Prescription Pad Format Changes to Take Effect July 1, 2006

Please note that there were changes to the Virginia Drug Control Actrelating to pharmaceutical prescription blank formats passed in the 2003 General Assembly which will take effect beginning July 1, 2006. Amendments which pertain to veterinary pharmaceutical prescribing are the deletion of Code of Virginia §54.1-3408.01 (B) and the addition of §54.1-32408.03. For your reference, the full text follows:

§ 54.1-3408.01. Requirements for prescriptions.
B. Pursuant to § 32.1-87, any prescription form shall include two boxes, one labeled "Voluntary Formulary Permitted" and the other labeled "Dispense As Written." A prescriber may indicate his permission for the dispensing of a drug product included in the Formulary upon signing a prescription form and marking the box labeled "Voluntary Formulary Permitted." A Voluntary Formulary product shall be dispensed if the prescriber fails to indicate his preference. If no Voluntary Formulary product is immediately available or if the patient objects to the dispensing of a generic drug, the pharmacist may dispense a brand name drug. Printed prescription forms shall provide:
"[ ] Dispense As Written
[ ] Voluntary Formulary Permitted
......
Signature of prescriber
If neither box is marked, a Voluntary Formulary product must be dispensed."
§ 54.1-3408.03. Dispensing of therapeutically equivalent drug product permitted.
A. A pharmacist may dispense a therapeutically equivalent drug product for a prescription that is written for a brand-name drug product unless (i) the prescriber indicates such substitution is not authorized by specifying on the prescription, "brand medically necessary" or (ii) the patient insists on the dispensing of the brand-name drug product.
In the case of an oral prescription, the prescriber's oral dispensing instructions regarding substitution shall be followed.
B. Prescribers using prescription blanks printed in compliance with Virginia law in effect on June 30, 2003, having two check boxes and referencing the Virginia Voluntary Formulary, may indicate, until July 1, 2006 [emphasis added], that substitution is not authorized by checking the "Dispense as Written" box. If the "Voluntary Formulary Permitted" box is checked on such prescription blanks or if neither box is checked, a pharmacist may dispense a therapeutically equivalent drug product pursuant to such prescriptions.

Please remember that the Board of Pharmacy addresses questions pertaining to the Drug Control Act. They may be reached via e-mail at .

Initial Rabies Inoculation Effectiveness Delay MustBe Noted on Rabies Certificates

At its February 3, 2005 meeting, the Board discussed a concern raised by the owner of a kitten that had been vaccinated for rabies six days prior to being bitten by an unidentified animal. The owner had not been made aware that it would require 28 days for the inoculation to be considered fully effective by health officials. Given the seriousness of rabies and the fact that the general public is most likely unaware of the latency in vaccination effectiveness, the Board voted to amend the Regulations to require that the rabies certificate for all initial rabies inoculations contain the following language:

Ananimal is not considered immunized for at least 28 days after the initial or primary vaccination is administered

The regulation became effective on October 8, 2005. Prior to that the Board had it posted as a guidance document on its website. This information was drawn from the U.S. Centers for Disease Control's latest recommendation and reporting relating to rabies in their Compendium of Animal Rabies Prevention and Control, 2004.

Fee reductions

To assure only necessary fees are imposed, a one-time reduction in renewal fees is in effect from October 15, 2005 to October 15, 2006. As such, for the December 2005 renewal, the renewal fee for veterinarians is $100, for veterinary technicians, $25, and for veterinary establishments, $120. For the 2006 renewal, the fees revert to $135, $30, and $140, respectively.

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Board Guidance on Medical Record Keeping

At its February 3, 2005 meeting, the Virginia Board of Veterinary Medicine developed general guidelines for its licensees regarding medical records. The primary goal of such guidelines is the protection of the patient as well as the public and to ensure that the practitioner is providing a minimum standard of care in daily practice.

Records should contain at a minimum:

• Presenting complaint/reason for contact;
• Physical examination findings if appropriate;
• Tests performed;
• Procedures performed/treatment given;
• Drugs (and their dosages) administered;
• Drugs (and their dosages) dispensed.

The Board is charged with upholding a minimum standard of care, and the above guidelines are intended to assist Virginia's veterinary practitioners to achieve that goal.

Board Guidance on Planing or Leveling Equine Teeth

With the assistance of an ad hoc committee on equine dentistry comprised of veterinarians, unlicensed equine dental technicians, and a Department inspector, the Board developed the following guidance at its August 10, 2005 meeting.

The planing or leveling of equine teeth by the use of non-motorized hand tools is not considered the practice of veterinary medicine and does not require a license. If sedation is required for planing and leveling, the sedation must be administered by a Virginia licensed veterinarian who remains responsible for the animal while it is under sedation.

This guidance was offered to clarify an earlier discussion that held that equine teeth "floating" was the practice of veterinary medicine since it had come to involve power tools and the use of sedatives to accomplish.

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Statistics

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Licensure

LICENSE TYPE / NUMBER*
VETERINARIANS / 3053
In-State, Active / 2133
In-State, Inactive / 42
Out-of -State, Active / 455
Out-of State, Inactive / 423
LICENSED VETERINARY TECHNICIANS / 1012
In-State, Active / 868
In-State, Inactive / 19
Out-of-State, Active / 109
Out-of-State, Inactive / 16
FULL SERVICE VETERINARY ESTABLISHMENTS / 662
RESTRICTED VETERINARY ESTABLISHMENTS / 184
In-State / 178
Out-of-State / 6
GRAND TOTAL / 4911

*Current Licenses - January 31, 2006

During 2005, 367 new licenses were issued. These included 212 veterinarians, 125 veterinary technicians, 22 full service veterinary establishments, and 8 restricted veterinary establishments. A total of 320 expirations and closures occurred this year, with 219 veterinarians, 82 licensed veterinary technicians, 9 full service veterinary establishments, and 10 restricted veterinary establishments. A very similar breakdown in initial licensure and expirationhas occurred for the past two years, with a net gain in licensees each year.

Discipline

In 2005, 173 cases were received by the Board, a 25% (139) increase over 2004.

The Board closed 136 cases, with 35 resulting in findings of violation. In 2004, the Board closed 123 cases, with 26 resulting in findings of violation.

To download or simply view case notices and orders, go to the Department of Health Professions website: select "Case Decisions" for the Board of Veterinary Medicine. There are links to cases closed within the last 90 days as well as a search-by-date capability.

2006 Board Meeting Calendar

Date / Meeting / Date / Meeting
1/19 / Informal Conferences / 7/13 / Informal Conferences
2/1 / FULL BOARD / 8/9 / FULL BOARD
2/2 / Informal Conferences & Panel Discussion / 8/10 / Informal Conferences
TBD / Equine Dentistry Ad Hoc Cte. / 6/15 / Informal Conferences
3/23 / Informal Conferences / 9/21 / Informal Conferences
4/13 / Informal Conferences / 10/18 / Informal Conferences
5/24 / FULL BOARD / 11/15 / FULL BOARD
5/25 / Informal Conferences / 11/16 / Informal Conferences

Note schedule is subject to change. For more information, contact the Board office at or 804-662-9915.

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